HCC 387: Pemphigus, Pemphigoid, and Other Specified Autoimmune Skin Disorders ICD-10-CM
CMS-HCC Category 387 (Pemphigus, Pemphigoid, and Other Specified Autoimmune Skin Disorders) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 0.125 and 0.658 to a beneficiary's RAF score depending on the payment segment (0.406 for a community, non-dual, aged enrollee). 14 ICD-10-CM diagnosis codes map to HCC 387. It sits at the top of its hierarchy: no other condition category supersedes it.
RAF Weight by Payment Segment 7 segments
| Payment Segment | Relative Factor |
|---|---|
| Community, non-dual, aged | 0.406 |
| Community, partial-benefit dual, aged | 0.477 |
| Community, full-benefit dual, aged | 0.658 |
| Community, non-dual, disabled | 0.302 |
| Community, partial-benefit dual, disabled | 0.498 |
| Community, full-benefit dual, disabled | 0.622 |
| Institutional | 0.125 |
A beneficiary is scored in exactly one segment, set by Medicaid (dual) status, aged or disabled entitlement, and residence. Factors are relative weights, not dollar amounts; new-enrollee segments score on demographics only. HCC 387 neither supersedes nor is superseded by any other category, so it always counts alongside unrelated HCCs.
ICD-10-CM Codes That Map to HCC 387 14 codes
- D86.3 Sarcoidosis of skin new to V28
- L10.0 Pemphigus vulgaris new to V28
- L10.1 Pemphigus vegetans new to V28
- L10.2 Pemphigus foliaceous new to V28
- L10.3 Brazilian pemphigus [fogo selvagem] new to V28
- L10.4 Pemphigus erythematosus new to V28
- L10.81 Paraneoplastic pemphigus new to V28
- L10.89 Other pemphigus new to V28
- L10.9 Pemphigus, unspecified new to V28
- L12.0 Bullous pemphigoid new to V28
- L12.1 Cicatricial pemphigoid new to V28
- L12.8 Other pemphigoid new to V28
- L12.9 Pemphigoid, unspecified new to V28
- L88 Pyoderma gangrenosum new to V28
Every code above carries the full HCC 387 weight when documented and reported on a Medicare Advantage encounter. The code link opens its full page with the complete risk adjustment card.
Questions About HCC 387
What is HCC 387 in the CMS-HCC model?
HCC 387 is CMS-HCC Category 387 (Pemphigus, Pemphigoid, and Other Specified Autoimmune Skin Disorders) in the V28 risk adjustment model. It covers 14 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.
What is the RAF weight for HCC 387?
For payment year 2026, HCC 387 adds 0.406 to the RAF score of a community, non-dual, aged beneficiary (living at home, age 65 or over, not also enrolled in Medicaid). The published weights range from 0.125 to 0.658 across the seven payment segments shown above.
Related References
Source: Centers for Medicare & Medicaid Services, Payment Year 2026 risk adjustment mapping and model software releases (CMS-HCC V28), applied to the FY 2026 ICD-10-CM code set. ICD List is not affiliated with CMS.
